Certain Ankle-Foot/Knee-Ankle-Foot (AFO/KAFO) Orthotics Codes Have a New Requirement for the Order and Office Visit

Seven (7) AFO/KAFO HCPCS codes have been added to the Required Face-to-Face Encounter and Written Order Prior to Delivery List effective for dates of service on or after April 17, 2023.

  • L1932, L1940, L1951, L1960, L1970, L2005, L2036

For items appearing on this list, the treating practitioner must document and communicate to the DMEPOS supplier that they had a face-to-face encounter with the patient within the 6 months before the date on the written order/prescription. The written order/prescription must be communicated to the supplier prior to delivery.

A face-to-face encounter means an in-person or CMS-approved telehealth encounter between the treating practitioner and the patient.

Additional information and the Required List can be found in MLN Matters SE20007, the Standard Documentation Requirements Article A55426, and the Noridian Orthotics webpage.

 

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